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Treating addiction: Rewriting patients’ country songs

Randi Sokol, MD, MPH
Physician
June 1, 2017
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Jimmy spent 10 years on the street chasing oxys and heroin. He lost his family and friends after lying and stealing. He lost his truck when the bank repossessed it. He lost his four-year-old son to the Department of Child Protective services. His life was like a country song.

Now a member of our suboxone group, Jimmy has two years of sobriety under his belt, he is enrolled at the local community college, and coaches his son’s soccer team.  It was his turn to check in and share with the group how his week went.

“Well,” he began in his calm, melodic voice, staring at his hands as he talked. “Me and my son were going to Burger King the other day. We got out of my truck, and this homeless guy came up to us, a bit older than me and very grubby. He asked me for some money so he could get food. I nodded at him, and me and my eight-year-old son walked into Burger King. As we were walking in, a man opened the door for us and said, ‘You know, that guy just wants money for drugs.’”

Jimmy took a deep breath and paused for a good 10 seconds. As the family medicine doctor facilitating the group, I looked around. How would everyone react to this story caked with judgment and stereotype yet simultaneously laced with truth? Many patients sitting at the table had likely found themselves hitting rock bottom at some point and begging for drug money and even food.

Jimmy continued to stare at his hands folded in front of him and began again, “Ten minutes later I came out of Burger King and gave the homeless man two Big Macs and two orders of fries.  He took them from me and said thank you, and me and my son got back in the truck.  As we pulled away, my son pointed out the window.  ‘Look, Daddy’ he said, as he watched the man fiercely biting into his hamburger.”

Jimmy then looked up, making eye contact with everyone in the group. “Who am I to judge people?  I was out there a few years ago. I was living the drug life, asking people for money. Doing stupid shit. But I’m grateful today that I don’t have to live like that.  I’m grateful that I can teach my son a good lesson in how to treat other people.”

Jimmy’s journey exemplifies why I love helping patients who struggle with addiction.

I have been facilitating our suboxone group for the past three years.  It is by far the highlight of the week for me and my team. It’s far from taking on a “population of addicts” — which is what I sometimes hear from colleagues.

Yes, patients with a history of addiction can be psychosocially complex.  But, unlike patients with chronic pain, who we sometimes question if they are abusing their medications, patients who seek treatment for addiction and truly embrace a life in recovery are no longer in the manipulative framework of mind.  Instead, they are honest about their problems, humble enough to discuss their past transgressions, and motivated to get help.

Helping patients battle their addiction is foundational to addressing their other health-related issues. It also represents the core of what family medicine is all about.  While I have never had patients continuously express gratitude for lowering their A1cs,  I have received significant gratitude for being present with patients during some of their most vulnerable moments and walking with them out of an active addiction.  As Jimmy’s story illustrates, we are then blessed to watch their lives grow and change over time in very authentic and meaningful ways.

As a colleague of mine likes to say, “treating patients who struggle with addiction is like a reverse country song … they get their kids back, they get their truck back, and they get their dog back. What can be more gratifying than that?”

I hope more colleagues will obtain training and begin using buprenorphine/naloxone to help patients rewrite their country song.

Randi Sokol is a family physician.  She is certified to lead buprenorphine waiver training sessions.

Image credit: Shutterstock.com

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Treating addiction: Rewriting patients’ country songs
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